National Institute of Arthritis & Musculoskeletal & Skin Diseases

As bone weakness progresses, the bones in the spine collapse which can result in pain, reduced height and kyphosis, a severe curvature of the upper spine. Extreme cases of kyphosis can impede breathing.

Hip fractures from osteoporosis can be fatal or result in long-term disability. A bone density test of the spine and hip can determine if you have or are at risk for osteoporosis. The DXA test, a non-invasive low dose x-ray, is the most widely used measure of bone density.

“If we live long enough,” Burnett-Bowie said, “chances are we will eventually suffer some bone loss.”

And that means trouble for those who choose to ignore the risks and fail to take preventive measures to combat osteoporosis, or low bone density, and other bone diseases.

The key is to start early in life when bones are developing in strength and size.

To further that goal, the federal Office on Women’s Health, for instance, has developed a program called “Best Bones Forever!” that encourages girls to get active in their health at an early age and consume foods high in calcium and vitamin D to maintain healthy bones throughout their lives.

Bone Growth/Loss

Active Growth
Children
and teens

Slow Loss
Mid-30s

Rapid Loss
After
menopause

Less Rapid loss
Seniors

After about age 30, you begin to slowly lose bone mass. This loss accelerates the first few years following menopause, and
continues at a slower pace in older men and women.

That’s because one of the biggest culprits in bone deterioration — and one of the most modifiable — is the lack of calcium and vitamin D. National nutrition surveys indicate that most people consume less than half of the minimum recommendations. “Both men and women should consume enough calcium and vitamin D throughout life,” Burnett-Bowie said. “Not just when you get older. Additionally, while osteoporosis affects women predominantly, roughly one-third of broken bones due to osteoporosis occur in men.”

Calcium is the most common mineral in the body and is a powerhouse. It helps muscles to contract, the heart to beat effectively, and the blood to clot. Almost all of the body’s calcium is stored in bones, but the body cannot absorb calcium without the help of vitamin D. When there is a deficit in vitamin D or dietary calcium, the body literally steals calcium from bones to make it available elsewhere. A normal heartbeat trumps bone strength.

The downside is the cost of weakening bones and the threat of osteoporosis.

Fortunately, calcium is readily available and can be found in a number of dairy and soy products and canned sardines or salmon (assuming you eat the bones). Though vitamin D comes predominantly from exposure to sunshine, fatty fish and fortified foods can help increase its levels.

But this is easier said than done, especially for blacks. Many African Americans are lactose-intolerant and shun dairy products. And because of darker skin, even exposure to sunshine is no guarantee that blacks will have sufficient levels of vitamin D.

Calcium and vitamin D supplements are recommended for those less tolerant of natural sources for the two.

Lifestyle is very important. Excessive alcohol and smoking are linked to decreased bone density. Lack of exercise is another problem. “Exercise and good muscle tone are important not only to keep bones strong, but also to reduce the risk of falling,” explained Burnett-Bowie. “If you fall less, you have a lower risk of fractures,” she said.

Weight-bearing exercises are essential. The pressure on bones during walking or running accelerates bone formation. Orthopedic surgeons now use weight-bearing casts for people with certain leg fractures to facilitate bone healing. Muscle strengthening exercises, like weight lifting, build muscle mass while impacting bones. Other exercises, such as bike riding and swimming, are helpful, but they do not exert as much pressure on bones. Balancing exercises — t’ai chi, for example — are helpful to maintain good posture and balance.

Unfortunately, studies have shown that many patients with osteoporosis are not receiving the appropriate advice or treatment. These findings are especially concerning because of the significant impact that sustaining a hip fracture has on one’s ability to function: 50 percent of seniors who break their hip never return to independent living.

That’s why Burnett-Bowie emphasizes the point. Osteoporosis is not a normal part of aging. Older people who fall from low heights should not break a bone, she cautioned.

“Even if you fall hard, that’s a red flag,” she said. “Tripping on the sidewalk should not result in a break.”